Lighthouse Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60249842 Issued in WA

Legal business name

LIGHTHOUSE FAMILY CLINIC LLC

Practice address

114 E Chance a la Mer NE
# 107
Ocean Shores, WA 98569-9202

Phone

(360) 940-7465

NPI assigned

Nov 29, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William Thomas Miller, ARNP

Title

Owner

Phone

(360) 940-7465

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ginger D. Scalone, FNP

  • Nurse Practitioner
  • Minnetonka, MN
  • NPI 1285919910

  Family

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1801163282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1574",
            "city": "OCEAN SHORES",
            "state": "WA",
            "postal_code": "985691574",
            "telephone_number": "360-940-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E CHANCE A LA MER NE",
            "address_2": "# 107",
            "city": "OCEAN SHORES",
            "state": "WA",
            "postal_code": "985699202",
            "telephone_number": "360-940-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-940-7465",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60249842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014973",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI NUMBER",
            "identifier": "603-142-599",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfred John Holm, MD
• Karla K Johnson, LMP
• Kyle Johnston, DPT, PT
• Wendy Marie Koca, COTA/L
• Barbara H Kraxberger, LIC. ACU DIPL OF ACU
• Laura Ann Lopez, DDS
• Michele Anita McKelvey
• Charles Calvin Morgan, DDS
• Ocean Shores Pharmacy PS
• Linnea Marie Papac

• Family Nurse Practitioner in Ocean Shores, WA
• Providers in Ocean Shores, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.